AB0260 ASSOCIATION BETWEEN INFLAMMATION AND DEPRESSIVE SYMPTOMS IN RHEUMATOID ARTHRITIS PATIENTS.
Authors: A. V. Meza Sánchez, C. Hernandez-Diaz, C. Duarte-Salazar, R. E. Barbosa-Cobos, I. Romero-Vazquez, L. Ventura, G. Lugo-Zamudio
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is an autoimmune, progressive disease characterized by an inflammatory process mediated by CD4+T lymphocytes leading to damage of the synovial membrane 1 . Its prevalence is estimated between 0.2 and 1.2% worldwide, affecting women in the fourth and fifth decades 2 . In 2013, the Mexican College of Rheumatology estimated a 1.6% prevalence 3 in Mexico. RA may affect patients´ social, psychological, economic and physical areas. Among its psychological implications, depression is one of the most important (with a prevalence of 40%) beyond the general population 4 . Several studies assess either prevalence or prognosis, despite its higher prevalence and a lesser likelihood of remission in these patients. Some investigations looked for a relationship between inflammation and depressive symptoms considering only clinical or biochemical parameters, despite the evidence supporting better results with imaging methods, such as musculoskeletal ultrasound (MSU). Objectives To identify the association between MSU demonstrated inflammation and the presence of depressive symptoms in RA patients. Methods In 2021 a cross-sectional study on RA patients (according to ACR/EULAR 2010 criteria) was conducted. The subjects were from the Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra” and Hospital Juárez de México Rheumatology out-patient clinic. Each patient underwent a clinical (SDAI, CDAI, and EVA), psychological (PHQ9 and InCaViSa questionnaires), and MSU assessment (7 joints score). Data described with central tendency and dispersion measures for quantitative variables and frequencies and proportions for qualitative variables. Kruskal Wallis, U Mann-Whitney and Spearman correlation tests for analysis done. Results Fifty-two patients (94% women) were evaluated, with a mean age of 56.06 (±12.31) years and duration of disease 13.66 (±9.44) years. Depression prevalence was 54%. Patients with disease activity had the highest depression scores (p=0.009), those with triggering events in the last six months (p=0.177), the leading event was the death of a close relative in 30% of the patients. A moderate correlation between the depression score (PHQ9) and clinical disease activity scores (SDAI, CDAI, VAS, and painful joints) (rho=0.553 [p&lt;0.001], 0.559 [p&lt;0.001], 0.492 [p&lt;0.001], and 0.57 [p&lt;0.001], respectively) were found. Furthermore, we found a moderate correlation between depression scores and psychological, social and physical quality of life. A mild correlation between MSU synovitis and depression scores (rho=0.315 [p=0.03]) found. Conclusion Patients with disease activity reported higher depression scores in comparison to remission patients. We demonstrated a relationship between depressive symptoms, social factors, disease perception and ultrasound synovitis. It is crucial to conduct longitudinal studies with a large number of patients, including a control group, and perform an adequate stratification of the demographic characteristics of the patients and their confounding variables. References [1]Karimzadeh H, Karami M, Bazgir N, Karimifar M, Yadegarfar G, Mohammadzadeh Z. Ultrasonographic findings of rheumatoid arthritis patients who are in clinical remission. J Res Med Sci 2018;23(1):38. [2]García de Yébenes M de J, Loza E. Artritis reumatoide: epidemiología e impacto sociosanitario. Reumatol Clin Supl 2018;14(2):3–6. [3]Hérnandez L del C, Querol J, De la Garza AL, Férnandez C. Artritis Reumatoide su impacto social y económico. Boletín Epidemiológico 2016;33(12):1–4. [4]Maldonado G, Ríos C, Paredes C, Ferro C, Intriago MJ, Aguirre C, et al. Depresión en artritis reumatoide. Rev Colomb Reumatol 2017;24(2):84–91. Disclosure of Interests None declared